Prognostic value of preoperative C-reactive protein concentration and white cell count in acute extremity ischaemia.

Objective: To find out if the C-reactive protein (CRP) concentration and the white cell count (WCC) are of any prognostic value in patients with acute extremity ischaemia.
Design: Retrospective study.
Setting: Tampere University Hospital and Jyväskylä Central Hospital, Finland.
Subjects: 129 patients with acute extremity ischaemia.
Main Outcome Measures: Preoperative CRP concentration, white cell count, packed cell volume, serum creatinine concentration, major amputation and death.
Results: The median (range) CRP concentration was 50.0 (3-271) mg/l in the 28 patients who underwent major amputation or died (group 1) and 11.0 (1.175) mg/l in the 65 patients who survived with viable limbs (group 2) (p = 0.007). The median (range) WCC was 13.1 (5.9-42.0) x 10(9)/l in group 1 (30 patients) and 9.5 (2.2-23.9) x 10(9)/l in group 2 (79 patients) (p < 0.001). The cut-off point of 20 mg/l for CRP and 11.0 x 10(9)/l for WCC had negative predictive values of 0.83 and 0.85 for amputation and mortality, respectively.
Conclusion: Preoperative CRP concentration and WCC correlated with limb salvage and mortality in patients with acute extremity ischaemia.